[P3-26] Analysis of Clinical Outcomes in Pediatric Bacterial Meningitis Focusing on Patients without Cerebrospinal Fluid Pleocytosis
[Introduction] Cerebrospinal fluid (CSF) cell count, biochemical examinations and cultures form the basis for the diagnosis of bacterial meningitis. However, some patients do not have typical findings and are at a higher risk of being missed or having delayed treatment. To better understand the correlation between CSF results and outcomes, we evaluated CSF data focusing on the patients with atypical findings.
[Methodology] This study enrolled CSF culture-proven bacterial meningitis patients aged from 1 month to 18 years in a medical center. The patients were divided into “normal” and “abnormal” groups for each laboratory result and in combination. The correlations between the laboratory results and the outcomes were analyzed.
[Results] A total of 175 children with confirmed bacterial meningitis were enrolled. In CSF examinations 16.2% of patients had normal white blood cell counts, 29.5% had normal glucose levels 24.5% had normal protein levels, 10.2% had normal results in two items, and 8.6% had normal results in all three items. In logistic regression analysis, a normal CSF leukocyte count and increased CSF protein level were related to poor outcomes. Patients with meningitis caused by Streptococcus pneumoniae and hyponatremia were at a higher risk of mortality and the development of sequelae.
[Conclusions] In children with bacterial meningitis, nontypical CSF findings and, in particular, normal CSF leukocyte count and increased protein level may indicate a worse prognosis.
[Methodology] This study enrolled CSF culture-proven bacterial meningitis patients aged from 1 month to 18 years in a medical center. The patients were divided into “normal” and “abnormal” groups for each laboratory result and in combination. The correlations between the laboratory results and the outcomes were analyzed.
[Results] A total of 175 children with confirmed bacterial meningitis were enrolled. In CSF examinations 16.2% of patients had normal white blood cell counts, 29.5% had normal glucose levels 24.5% had normal protein levels, 10.2% had normal results in two items, and 8.6% had normal results in all three items. In logistic regression analysis, a normal CSF leukocyte count and increased CSF protein level were related to poor outcomes. Patients with meningitis caused by Streptococcus pneumoniae and hyponatremia were at a higher risk of mortality and the development of sequelae.
[Conclusions] In children with bacterial meningitis, nontypical CSF findings and, in particular, normal CSF leukocyte count and increased protein level may indicate a worse prognosis.